thereby becoming a potential source of cross-contamination . ( But to our knowledge , no vendor has included such a recommendation in their user manuals ).”
“ One of the key recommendations we make in our report is for device manufacturers to examine their instructions for cleaning and disinfecting ventilator components and make sure that they are complete , clear , well documented , and realistically achievable ,” Schluth says . “ The instructions should specify which steps are needed , and when , for all essential ventilator components .” ECRI ’ s recommendations include :
• Use single-use items whenever possible .
• Use at least one filter in the breathing circuit between the patient and the exhalation valve when ventilating a patient infected with a known or suspected pathogen , and verify that the filter is appropriate for the known or suspected pathogen .
• Even if one or more filters are used , perform high-level disinfection on any reusable ventilator components , including exhalation valves , that may contact exhaled patient gas .
• Perform low-level disinfection of external ventilator surfaces between patients .
• Perform high-level disinfection on any reusable breathing circuits between patients .
The full Top 10 Health Technology Hazards report , accessible to ECRI members , provides detailed steps that organizations can proactively take to prevent adverse incidents . An executive brief version is available for complimentary download at www . ecri . org / 2023hazards
References :
ECRI . Top 10 Health Technology Hazards for 2023 . ECRI . Supply Chain Shortfalls Pose Risks to Patient Care . Device Evaluation .
Jan . 12 . 2022 . ECRI . Safe Cleaning and Disinfection of Ventilators : ECRI ’ s Recommendations .
Oct . 6 , 2021 . ECRI . Don ’ t Lose the Evidence — Sequestering Equipment after an Incident .
March 5 , 2014 .
Infection Preventionists and Technology : A Q & A With Marie H . Wilson , MSN , RN , CIC
Marie H . Wilson , MSN , RN , CIC , is an infection preventionist in the Quality Division , Fred Hutchinson Cancer Center .
HHM ECRI is among many patient safety organizations issuing annual alerts about technology-related hazards in healthcare ; in your opinion , to what degree are today ’ s clinicians / IPs prepared to interact with this technology , and what could be done to make sure they are better educated and trained ?
Marie H . Wilson ( MHW ): Many of the hazards noted by ECRI are likely familiar obstacles for infection preventionists ( IPs ), especially after the pandemic . Yet , there is always room for IPs to expand our knowledge and comfort with technology influencing healthcare delivery . It is not unusual for a new technology to be introduced that seemingly has nothing to do with infection prevention , and yet we ’ ll play a major role in its roll-out , maintenance or follow-up in the event of an issue with its use .
HHM How important is it for clinicians to be familiar with their facility / system ’ s biomedical engineering staff to facilitate learning around technology-driven patient-care equipment ?
MHW : Biomedical engineering is an essential department with which IPs should partner . We ’ re aligned in our missions to maintain safe healthcare delivery through preventive maintenance , so it is natural to establish relationships and maintain open lines of communication , especially when new equipment is brought in . Together , we can ensure the use is safest for staff , patients , and others in the environment from day one .
HHM Veteran practitioners still engage in “ shoe-leather ” epidemiology , so how can old-school approaches be blended with today ’ s technology-driven approaches like EMRs , etc .?
MHW : The old adage of “ seeing is believing ” will never lose its place in infection prevention . Going to where the work is occurring ( i . e ., Gemba walks ) will continue to be an important tool for IPs to connect what they ’ re seeing documented in the EMR with how it is occurring at the bedside . Not to mention the relationships that can be established with key stakeholders during these walkabouts .
HHM IPs are beginning to encounter a lot more infection prevention-associated technology , with EHRs , automated compliance-monitoring systems , vascular access devices , ventilators ( COVID-related challenges ), UV robots , etc ., so how can they ensure they are up-to-speed on this technology and the ramifications for IP & C and patient / healthcare worker safety ?
MHW : Healthcare organizations should strongly consider having IPs at the table for new technology decision-making . I ’ ve seen capital expenditures made on equipment that wasn ’ t compatible with established processes for cleaning and disinfection , severely prohibiting its use until addressed . Similarly , decisions about software impacting how HAI surveillance of publicly reportable infections occurs should include an IP , as disruptions in this critical function could have serious financial implications for the organization . To effectively communicate and critically think through the implications of these new technologies , IPs should seek out educational opportunities related to new technologies from vendors , scholarly journal articles , and trade magazines , for example , so that if the product should be considered for the organization , the infection preventionist has familiarity with its use . Additionally , asking vendors for other organizations that use the product and reaching out directly to their infection prevention teams for key learning from its implementation can save a lot of headaches down the road .